Flaccid leg paralysis caused by a thoracic epidural catheterization: a case report
Byoung Hyun Jeon1, Heui Je Bang, Gyung Moo Lee
1Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Annals of Rehabilitation Medicine
|July 23, 2013
Summary
A patient developed leg paralysis and sensory loss after thoracic epidural catheterization. Magnetic resonance imaging revealed spinal cord lesions, suggesting epidural anesthesia complications.
Area of Science:
- Neurology
- Anesthesiology
- Spinal Cord Medicine
Background:
- Thoracic epidural catheterization is a common procedure for postoperative pain management.
- Complications, though rare, can significantly impact neurological function.
Purpose of the Study:
- To report a case of spinal cord and nerve root injury following thoracic epidural catheterization.
- To investigate the potential link between epidural catheterization and neurological deficits.
Main Methods:
- Case report of a 44-year-old patient experiencing left leg paralysis post-abdominal surgery.
- Utilized magnetic resonance imaging (MRI) to visualize spinal cord abnormalities.
- Performed electrodiagnostic examinations to assess nerve root function.
Main Results:
- Patient presented with sensory loss below T10 and left leg motor weakness.
- MRI revealed intramedullary spinal cord lesions (T9-L1) and cauda equina enhancement.
- Electrodiagnostic tests indicated lumbosacral polyradiculopathy affecting left-sided nerve roots below L4.
Conclusions:
- Epidural catheterization may cause intrinsic spinal cord and nerve root lesions.
- Local anesthetic injection via epidural catheter is a potential causative factor.
- This case highlights the importance of recognizing neurological complications associated with epidural anesthesia.
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